清解化瘀汤联合甲泼尼龙治疗小儿过敏性紫癜(血热妄行证)的临床效果  

Clinical efficacy of Qingjie Huayu Decoction combined with methylprednisolone for the treatment of henoch-schonlein purpura in children(blood heat delusion syndrome)

作　　者：李霞[1] 吉慧 史艳平[1] 田纪凤 孔俊飞 LI Xia;JI Hui;SHI Yanping;TIAN Jifeng;KONG Junfei(Department of Integrated TCM&Western Medicine Xi’an Children’s Hospital,Xi’an 710000,China)

机构地区：[1]西安市儿童医院中西医结合科,西安710000

出　　处：《西北药学杂志》2025年第2期212-217,共6页Northwest Pharmaceutical Journal

基　　金：西安市卫生健康委员会青年培育项目(编号:2023qn14)。

摘　　要：目的探讨清解化瘀汤联合甲泼尼龙治疗小儿过敏性紫癜(henoch-schonlein purpura,HSP)(血热妄行证)的临床效果。方法选取2022年9月—2023年9月收治的200例HSP(血热妄行证)患儿,采用随机数字表法将其分为对照组(100例)和观察组(100例)。对照组给予甲泼尼龙治疗,观察组给予清解化瘀汤联合甲泼尼龙治疗。比较2组患儿治疗前后的中医证候(traditional Chinese medicine,TCM)积分、临床症状消失时间、治疗前后的炎性因子[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、免疫球蛋白表达[免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)]、治疗后的临床疗效、不良反应发生率以及随访6个月的复发率。结果治疗后,2组的TCM积分、IL-6、TNF-α、IgA、IgG、IgM均降低(P<0.05),且观察组均低于对照组(P<0.05);观察组的皮疹紫癜消退时间、关节痛消失时间、消化道症状消失时间均短于对照组(P<0.05);观察组的临床总有效率高于对照组(P<0.05);2组总不良反应发生率、随访期间复发率比较差异均无统计学意义(P>0.05)。结论清解化瘀汤联合甲泼尼龙治疗可有效改善小儿HSP的临床症状,减轻炎症反应,调节免疫功能,具有较好的临床疗效和安全性,且复发率较低,值得临床应用。Objective To explore the clinical efficacy of Qingjie Huayu Decoction combined with methylprednisolone for the treatment of children diagnosed with henoch-schonlein purpura(HSP)(blood heat delusion syndrome).Methods A total of 200 children with HSP(blood heat delusion syndrome)admitted to our hospital between September 2022 and September 2023 were selected and divided into the control group(100 cases)and the observation group(100 cases)using a random number table method.The control group received treatment with methylprednisolone,while the observation group was given Qingjie Huayu Decoction combined with methylprednisolone.The traditional Chinese medicine(TCM)syndrome scores,disappearance time of clinical symptoms,levels of inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],immunoglobulin expression[immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)]before and after treatment,clinical efficacy following treatment,incidence of adverse reactions and recurrence rate after 6-month of follow-up were compared between the 2 groups.Results After treatment,the TCM scores,IL-6,TNF-α,IgA,IgG and IgM in the 2 groups decreased(P<0.05),and those in the observation group were lower than the control group(P<0.05).The disappearance time of rash and purpura,disappearance time of joint pain and disappearance time of gastrointestinal symptoms in the observation group were shorter than those in the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).There was no statistically significant difference in the incidence rate of total adverse reactions and recurrence rate during follow-up between the 2 groups(P>0.05).Conclusion Qingjie Huayu Decoction combined with methylprednisolone can effectively improve the clinical symptoms of HSP in children,reduce the inflammatory responses and regulate the immune function,and it has good clinical efficacy and safety,and has lower recurrence rate,which is worthy of clinical application

关 键 词：过敏性紫癜 血热妄行证 清解化瘀汤 甲泼尼龙 临床效果 

分 类 号：R973[医药卫生—药品]